Arthroscopic Single-Portal Suprapectoral Biceps Tenodesis With All-Suture Anchor

Abstract

Tenodesis of the long head of the biceps tendon can be performed through arthroscopic and open techniques with various fixation methods and at different locations on the humerus. Many techniques have been described, with controversy surrounding the advantages and disadvantages of each. In this Technical Note, we describe an allarthroscopic, intra-articular, single-portal, suprapectoral biceps tenodesis with an all-suture anchor. This technique also allows for suture passage through the biceps tendon before tenotomy to ensure proper maintenance of the lengthetension relationship of the biceps musculotendinous unit.

Arthroscopic In Situ Biceps Tenodesis Using a Double Loop-and-Tack Knotless Suture Anchor

“…Various techniques have been described for tenodesis of the LHBT, which differ in approach (open versus arthroscopic), location (intra-articular proximal to the biceps sling versus extra-articular suprapectoral or subpectoral within the bicipital groove), and fixation method (e.g., soft tissue simple suture, polymer versus all-suture anchor, interference screw, bone tunnels). 6 , 7 , 8 , 9 To date, no single technique has been shown to be superior. The surgeon should use clinical judgement to select the most effective and reproducible technique that addresses the main goals of 1) maintaining physiological LHBT tension, 2) achieving secure fixation, and 3) removing or decompressing pathologic tissue.…”

Modified arthroscopic intra-articular transtendinous looped biceps tenodesis leads to satisfactory functional outcomes and less frequent Popeye deformity compared to biceps tenotomy

“…Numerous surgical techniques have been proposed for biceps tenodesis [ 10 – 12 ]. Some surgeons prefer suprapectoral biceps tenodesis as it can be performed arthroscopically [ 6 , 20 ], whereas others prefer open subpectoral tenodesis because the surgical procedure is simple and allows treatment of lesions located in the bicipital groove [ 9 , 19 ]. Among the techniques for arthroscopic suprapectoral tenodesis, some surgeons favor the transtendinous technique for tenodesis as it helps suture the tendon in arthroscopy surgery [ 16 , 25 ].…”

Biomechanical properties of suprapectoral biceps tenodesis with double-anchor knotless luggage tag sutures vs. subpectoral biceps tenodesis with single-anchor whipstitch suture using all-suture anchors

“…Although several recent studies have investigated the biomechanical properties of all-suture anchors for subpectoral 3 , 10 , 20 , 23 , 29 and suprapectoral 16 biceps tenodeses, no prior study has directly compared the biomechanical properties of knotless all-suture anchors for subpectoral vs. suprapectoral biceps tenodeses. Moreover, while the surgical technique for suprapectoral biceps tenodesis with 2 luggage tag sutures has been described using a SwiveLock anchor (Arthrex, Naples FL, USA) 14 or a single all-suture anchor, 14 , 18 no previous study has evaluated the biomechanical properties, including load to failure and displacement, of a suprapectoral biceps tenodesis performed with 2 luggage tag sutures and 2 all-suture anchors.…”